Equipment Repair Form

Please complete then print  this page and include it with your equipment.
Information entered here is not saved or downloaded to us.
You must contact us for shipping information.

Customer Information:

Name
Company Name
Address
City StateZip
Phone#1 Phone#2
Email

Equipment Information:
 
Make Model
Serial #

Description of problems with equipment:

Payment Information:
We will contact you for credit card information after we receive your equipment.
A diagnostic fee of $145 is required. This fee gets deducted from final repair bill.
You can include a $145 check with your equipment for the diagnostic.
You will be notified as to the results of the diagnostic and total repair charge before repairs are completed.
Please call 719-550-5810 is you have any questions or concerns.

Special Instructions: